Rehabilitation Approaches for Shoulder Pain

Overseen By Abigail Anderson

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: University of Central Florida

Disqualifiers: Non-English, Uncontrolled diabetes, Hemophilia, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 8

Duration: 4 weeks

24 Participants Needed

Trial Summary

Do I have to stop taking my current medications for the trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What data supports the idea that Rehabilitation Approaches for Shoulder Pain is an effective treatment?

The available research shows that while Rehabilitation Approaches for Shoulder Pain, which include biopsychosocial methods, are widely used, there is questionable scientific evidence supporting their effectiveness specifically for shoulder pain. However, similar approaches have shown improvement in disability and pain for spinal disorders, suggesting potential benefits. This treatment requires a lot of resources and collaboration, but it aims to address both physical and mental aspects of pain, which might help some patients. ^{1 2 3 4 5}

What safety data exists for biopsychosocial treatments for shoulder pain?

The provided research does not explicitly mention safety data for biopsychosocial treatments for shoulder pain. However, it highlights that these treatments are widely used despite questionable scientific evidence of their effectiveness. The studies emphasize the need for substantial resources and collaboration among patients, rehabilitation teams, and workplaces. They also suggest that these programs can lead to pain reduction, improved quality of life, and better psychosocial functioning, but specific safety data is not detailed. ^{3 4 5 6 7}

Is the Biopsychosocial Intervention a promising treatment for shoulder pain?

The Biopsychosocial Intervention is a promising treatment for shoulder pain because it focuses on the whole person, addressing physical, mental, and social aspects of pain. This approach is widely used and can help improve the patient's ability to manage pain and function better in daily life. ^{1 3 4 5 8}

What is the purpose of this trial?

This pilot study will assess feasibility and obtain preliminary effects of a tissue based intervention to a biopsychosocial intervention in individuals with shoulder pain.

Research Team

Abigail Anderson

Principal Investigator

University of Central Florida

Eligibility Criteria

This trial is for individuals experiencing shoulder pain with an intensity of at least 3 out of 10 in the past day. Specific eligibility details are not fully listed, but typically participants would need to meet certain health criteria.

Inclusion Criteria

My shoulder pain has been 3 or more out of 10 in the last day.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants receive either a tissue-based intervention or a biopsychosocial intervention over eight sessions

4 weeks

8 sessions (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Biopsychosocial Intervention
• Tissue Intervention

Trial Overview The study compares two treatments for shoulder pain: a tissue-based intervention (likely involving physical therapy or similar techniques) and a biopsychosocial intervention (which considers psychological and social factors along with biological).

Participant Groups

Group I: Tissue Intervention Experimental Treatment 1 Intervention

Participants will attend eight sessions. During each session, participants will receive education on positions of comfort, progressing activities, and return to function. Participants will complete shoulder stretching and strengthening exercises according to a protocol.

Group II: Biopsychosocial Intervention Active Control 1 Intervention

Participants will attend eight sessions. During each session, participants will receive education on pain neuroscience education, stress management, and maintaining physical activity. Participants will complete shoulder stretching and strengthening exercises according to a graded exercise protocol.

Who Is Running the Clinical Trial?

University of Central Florida

Lead Sponsor

Trials

101

Recruited

1,191,000+

Findings from Research

In a study of 78 patients with atraumatic shoulder pain, those who showed clinical improvement after 3 months of nonoperative treatment had significantly higher self-efficacy scores, suggesting that belief in their ability to manage symptoms plays a crucial role in recovery.

Patients who improved reported lower pain levels compared to those who did not improve, indicating that enhancing self-efficacy may be an important strategy in managing shoulder pain effectively.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of self-efficacy on nonoperative treatment of atraumatic shoulder pain. Grandizio, LC., Choe, LJ., Follett, L., et al.[2022]

The study developed 51 process indicators to evaluate how well manual physical therapists (MPTs) take biopsychosocial histories in patients with chronic back and neck pain, revealing that while somatic history taking was excellent (98.3%), psychological and social dimensions were inadequately addressed, with scores as low as 18.2%.

There was a significant gap between MPTs' self-assessment and actual performance, as they believed they were adequately covering psychological aspects, while the data showed much lower effectiveness, highlighting the need for improved training in biopsychosocial approaches.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Manual physical therapists' use of biopsychosocial history taking in the management of patients with back or neck pain in clinical practice. Oostendorp, RA., Elvers, H., Mikołajewska, E., et al.[2018]

A systematic review of multidisciplinary biopsychosocial rehabilitation for neck and shoulder pain found only 2 relevant studies, both of which had low methodological quality, indicating a lack of strong scientific evidence for its effectiveness.

Despite being widely used, the review concluded that there is limited evidence supporting the efficacy of these rehabilitation programs compared to other treatment options, highlighting the need for higher quality research in this area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Multidisciplinary biopsychosocial rehabilitation for neck and shoulder pain among working age adults. Karjalainen, K., Malmivaara, A., van Tulder, M., et al.[2018]

A systematic review of multidisciplinary biopsychosocial rehabilitation for neck and shoulder pain found only two relevant studies, both of which had low methodological quality, indicating a lack of robust evidence for its effectiveness.

Despite being widely used, the review concluded that there is limited scientific support for the efficacy of these rehabilitation programs compared to other treatment options, highlighting the need for higher quality research in this area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Multidisciplinary biopsychosocial rehabilitation for neck and shoulder pain among working age adults. Karjalainen, K., Malmivaara, A., van Tulder, M., et al.[2022]

Physical therapist-led interventions based on the biopsychosocial (BPS) model significantly reduce pain intensity in patients with spinal disorders, showing clinically meaningful effects in the short and medium term, with standardized mean differences of -0.44 and -0.24, respectively.

These BPS model interventions also effectively decrease disability in patients, with significant improvements observed across all time frames (short, medium, and long term), indicated by standardized mean differences of -0.48, -0.44, and -0.37, although the overall quality of evidence was low.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physical therapist-led interventions based on the biopsychosocial model provide improvement in disability and pain for spinal disorders: A systematic review and meta-analysis. Miki, T., Kondo, Y., Kurakata, H., et al.[2023]

Multidisciplinary pain management programs that use a biopsychosocial approach can lead to significant pain reduction and improvements in quality of life and psychosocial functioning.

Successful outcomes, including return-to-work and vocational improvements, depend on effective communication and collaboration among a diverse treatment team, which may include various healthcare professionals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Multidisciplinary and interdisciplinary management of chronic pain. Stanos, S., Houle, TT.[2022]

The biopsychosocial approach is effective for managing chronic pain by integrating education, cognitive-behavioral therapy, and relaxation techniques, helping patients control their thoughts and emotions related to pain.

This approach not only addresses the psychological and social factors of pain but also complements traditional medical care, making it a comprehensive treatment strategy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Psychosocial therapies for neck pain. Victor, L., Richeimer, SM.[2019]

There is moderate evidence that multidisciplinary rehabilitation programs, which include workplace visits, can effectively help working-age adults with subacute low back pain return to work faster and reduce sick leave.

Only two relevant studies were found, both of which had low methodological quality, highlighting the need for more rigorous research to confirm the effectiveness of these rehabilitation programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Multidisciplinary biopsychosocial rehabilitation for subacute low back pain among working age adults. Karjalainen, K., Malmivaara, A., van Tulder, M., et al.[2018]

References

1. Germany pubmed.ncbi.nlm.nih.gov

The impact of self-efficacy on nonoperative treatment of atraumatic shoulder pain. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Manual physical therapists' use of biopsychosocial history taking in the management of patients with back or neck pain in clinical practice. [2018]

3. England pubmed.ncbi.nlm.nih.gov

Multidisciplinary biopsychosocial rehabilitation for neck and shoulder pain among working age adults. [2018]

4. England pubmed.ncbi.nlm.nih.gov

Multidisciplinary biopsychosocial rehabilitation for neck and shoulder pain among working age adults. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Physical therapist-led interventions based on the biopsychosocial model provide improvement in disability and pain for spinal disorders: A systematic review and meta-analysis. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

Multidisciplinary and interdisciplinary management of chronic pain. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Psychosocial therapies for neck pain. [2019]

8. England pubmed.ncbi.nlm.nih.gov

Multidisciplinary biopsychosocial rehabilitation for subacute low back pain among working age adults. [2018]